胃癌术后瑞能早期肠内营养的应用

目的观察胃癌术后瑞能(Supportan)早期肠内营养支持的效果。方法选择胃癌术后患者共148例,分成两组,A组为鼻空肠组,B组为对照组。A组应用肠内营养输注系统,在手术后6h开始均匀输注瑞能,观察肠内营养支持期间的临床表现,并测定肠内营养支持前、后患者的血常规、血糖、肝肾功能、电解质和营养指标,以及术后并发症。结果术后肛门排气恢复时间A组比B组早(P<0.01);A组应用瑞能后2例出现恶心、呕吐,经减慢输注速度后缓解,2例出现腹痛,经调整温度后缓解。所有患者没有出现腹泻、急性机械性肠梗阻、肠瘘和代谢性并发症。A组应用瑞能后,前清蛋白比B组升高(P<0.05),视黄醇结合蛋白也比B组明显升高(P<0.01)。结论胃癌术后通过鼻空肠管应用瑞能进行早期肠内营养支持是安全有效的,有利于胃肠功能的恢复,对改善患者机体的营养状况具有积极意义,也易为患者所接受。

Early enteral nutrition with supportan after gastronal carcinoma operation

Objective To study the effect of early enteral nutrition using supportan after gastronal carcinoma operation.Methods 148 postoprative patient s were divided into two groups.The jejunostic tube group(A group,n=80) received the enteral nutrition(Supportan) 6h after operation,and the control group(B group,n=68) received the intravenous infusion and then the oral liquid diet after the bowel movement recovery.The clinical findings,operative complications,blood glucose,the function of liver and kidney,elect rolytes and nut ritional status were observed.Results The recovery of bowel movement in group A was much earlier than that in group B(P<0.01).Nausea and vomiting occured in two patient and relieved by slowing the administ ration rate in group A.Abdominal pain occurred in two patients and relieved by regulating the temperature of supportan in group A.No patient had the complications such as diarrhea,intestinal obst ruction,intestinal fistula and metabolic disorder in group A and the levels of prealbumin and RBP were significantly higher in group A than those in the cont rol group.ConclusionUsing supportan for early enteral nut rition through jejunostic tube is safe and effective after gastronal carcinoma operation.It is beneficial to the recovery of gastrointestinal function and has a positive role in improving the patient’s nutritional status.